What are the classification criteria for large-vessel vasculitides?

Updated: Dec 10, 2018
  • Author: Nadia Jennifer Chiara Luca, MD; Chief Editor: Lawrence K Jung, MD  more...
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Answer

Note that the main large vessel vasculitis that affects children is Takayasu arteritis, and that temporal arteritis is not seen in the pediatric population. Takayasu arteritis is characterized by transmural inflammation and evidence of intramural giant cells. It involves the aorta and its major branches. Characteristic clinical features are caused by stenotic large vessels and subsequently decreased blood supply to the organ systems. Classically, children present with claudication, absent peripheral pulses, blood pressure abnormalities, strokes, and features of internal organ ischemia. A literature review by Duarte et al found an estimated prevalence of stroke/transient ischemic attack in patients with Takayasu arteritis of almost 16%. [3]

Classification criteria for Takayasu arteritis includes angiographic abnormalities (conventional, CT, or MRI) of the aorta or its main branches (mandatory criterion), plus at least one of the following features:

  • Decreased peripheral artery pulse and/or claudication of extremities

  • Blood pressure difference of more than 10 mm Hg

  • Bruits over aorta and/or its major branches

  • Hypertension (related to childhood normative data)


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